What to expect at an infertility appointment (for men)

Fertility problems are a shared concern, so it's best if you and your partner go to the first appointment together.

Get copies of your health records if you don't already have them, and send them to your doctor ahead of time. This can be time-consuming, but it's worth the effort. Having access to your records enables your doctor to review your situation beforehand, and saves you the hassle and expense of duplicating medical tests.

As part of the evaluation, expect to be asked about your sexual history, whether you've ever had any sexually transmitted infections, how often you make love, and more. Not much about your private life will be private anymore, so it's important to feel comfortable with your doctor. (For details about what your doctor may ask your partner, see the female fertility worksheet.)

Note: Your healthcare provider will also do a complete physical exam, including a thorough examination of your genitals, though possibly at a separate visit. You'll also be asked to provide a semen sample so the number and quality of sperm can be checked. (You may need to abstain from sex for two to five days before you give the sample.)

The fertility specialist also may ask you questions similar to the ones listed below.

Medical history

Were you born with undescended testicles?

Why they ask: If one or both testicles remain inside the abdomen too long, body warmth can permanently affect sperm production.

Have you had an illness with a high fever in the last six months?

Why they ask: A fever can damage sperm production temporarily.

Have you noticed swelling or pain in your testicles recently? Have you sustained any injuries to your testicles? Have you ever had a testicular torsion?

Why they ask: Torsion results when the testicle twists inside your scrotum, affecting fertility. And a blow to the groin can cause inflammation that may temporarily affect sperm quantity.

Have you ever had a tumor or cyst in your testicles?

Why they ask: A previous surgical procedure – to remove a testicular cyst, for example – can sometimes cause scarring that affects fertility.

Have you ever had X-rays of your groin area?

Why they ask: A shield is typically used to protect the testicles from radiation, but accidental exposure can cause sperm problems.

Do you have chronic bladder or urinary tract infections? Is your urine cloudy, or do you feel a burning sensation when urinating?

Why they ask: Symptoms of some sexually transmitted infections include a burning sensation when urinating. If such an infection is passed on to your female partner, it could damage her fallopian tubes.

Have you ever had cancer requiring chemotherapy or radiation therapy?

Why they ask: Cancer treatments, such as radiation therapy and chemotherapy, can kill sperm, sometimes temporarily and sometimes permanently.

Do you have a chronic illness, such as diabetes or thyroid disease?

Why they ask: These conditions, and some of their treatments, have been linked to fertility problems.

Do you take any medications?

Why they ask: Steroids and high blood pressure medication – especially calcium channel blockers – have been known to interfere with fertility.

Have you had the mumps? How old were you?

Why they ask: Having the mumps (especially after puberty) has been associated with low sperm production.

Are you a Gulf War veteran? Were you ever exposed to any environmental toxins such as Agent Orange?

Why they ask: These chemicals have been linked to fertility problems in men.

Sexual history

Have you ever tested positive for a sexually transmitted infection? If so, which one?

Why they ask: If you pass chlamydia and gonorrhea on to your partner, they can cause inflammation that may block your partner's tubes or harm her reproductive organs.

Have you had a vasectomy? Or a reversal?

Why they ask: Reversing a sterilization procedure isn't foolproof. Scar tissue can still prevent sperm from being ejaculated. And even when reversals work, some men develop sperm antibodies that can kill or disable sperm.

Are you having any sexual difficulties?

Why they ask: If you're having difficulty getting or maintaining an erection, or having problems ejaculating, it's hard to have sex that leads to pregnancy. Your doctor may be able to prescribe medication that will help.

Family history

Have any family members had problems with genetic defects or stillbirths?

Why they ask: Some fertility problems are genetic. You may want to gently ask your relatives – particularly childless couples or families with an only child – about their fertility history.

Lifestyle

Do you smoke cigarettes? If so, how many packs a week?

Why they ask: Some evidence has shown that the nicotine in cigarettes can lower sperm counts. Learn more about tools to help you quit smoking.

Do you use recreational drugs? If so, which ones and how often?

Why they ask: Recreational drugs have been associated with reduced fertility in both men and women, though more research is needed to confirm direct cause and effect.

Do you take hot baths or use hot tubs?

Why they ask: Some studies have shown that heat can interfere with sperm production. Consider not using hot tubs or taking hot baths to avoid this risk.

Are you a bike rider? How often do you ride?

Why they ask: Some early evidence suggests that pressure on the groin and heat around the scrotum from long periods of bicycling can harm sperm production.

Do you work with chemicals (including pesticides) or radiation?

Why they ask: Exposure to these elements can adversely affect sperm production.

What is your typical diet?

Why they ask: Men with healthy diets have better semen quality.

Questions you may have

You may want to ask your provider questions too. Here are some to consider:

What might be causing our infertility?

Do we need further tests? If so, which ones?

What are our possible treatment options?

What do you suggest we try first? What are the benefits of this treatment? What are the possible side effects, both long-term and short-term?

What are other possible options for us?

What would each of these options involve?

What are the chances we'd conceive twins or other multiples with the option you're recommending?

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